Family Planning Expansions

Since the 1990s, many states have broadened eligibility for their Medicaid programs to provide family planning services and supplies to individuals who are not otherwise eligible for Medicaid. Originally these expansions were authorized through a Medicaid demonstration waiver authorized by §1115 of the Social Security Act, an important tool that continues to allow states to test out innovative ideas in the administration of their Medicaid programs.

Recognizing the effectiveness of these programs, Congress included a provision in the Affordable Care Act (ACA) giving states the option to amend their state Medicaid plans to expand eligibility for family planning services and supplies to individuals who are not pregnant and who have an income that does not exceed the income-eligibility level set by the state for coverage for pregnancy-related care. These amendments are called "state plan amendments," or SPAs.

More than half of the states now operate a Medicaid family planning expansion program through a state plan amendment (SPA), as authorized by the ACA, or through a §1115 demonstration waiver.


NFPRHA works to support the adoption, continuation, and improvement of Medicaid family planning expansion programs, at both the state and federal levels. Since 2007, NFPRHA has been bringing together family planning program administrators and state Medicaid program staff through its Medicaid Peer-to-Peer meeting series to discuss key issues related to Medicaid-funded family planning, identify mutual areas of concern and share best practices for operating Medicaid family planning expansion programs. 


Fact Sheets

Other Resources

For additional resources & information, access NFPRHA fact sheets and federal comments by issue or read NFPRHA's publications and press statements.



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